Oral Versus Intravenous Iron for Treatment of Iron Deficiency Anaemia in Pregnancy: A Randomized Controlled Trial

Oral iron supplementation is standard of care in obstetrical practice in pregnancy. But oral iron is frequently restricted by limited absorption, low tolerability, non-compliance and side effects. Intravenous iron could be a good alternative with sure compliance.

To evaluate the efficacy and adverse effects of intravenous iron sucrose and compare it with oral ferrous sulphate therapy in the treatment of iron deficiency anaemia of pregnancy.

A randomised, open labelled, controlled trial was performed in a tertiary care hospital. 150 Women at 26 to 34 weeks of gestation with haemoglobin between 7–11 g/dl who met the inclusion criteria were randomised into oral iron group I and intravenous iron sucrose group II. Patients were followed till delivery. Haemoglobin levels, reticulocyte count, serum ferritin levels were analysed to compare efficacy and safety.

Rise in haemoglobin level was more in group II as compared to group I in total and in terms of period of gestation and gravidity. The rise in reticulocyte count was higher in group I at the end of 1 week. The rise in ferritin was very highly significant in subjects of both groups recruited at any period of gestation at 4 weeks after therapy (p<0.001).

Intravenous Iron sucrose is a safe and an effective alternative to oral iron. Iron sucrose restores iron stores faster and more effectively than oral iron in terms of rise in haemoglobin, reticulocyte count, serum ferritin levels and without any serious side effects.